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1.
Artigo em Inglês | MEDLINE | ID: mdl-33558283

RESUMO

Improvements in the translational value of preclinical models can allow more-successful and more-focused research on shortening the duration of tuberculosis treatment. Although the hollow-fiber infection model (HFIM) is considered a valuable addition to the drug development pipeline, its exact role has not been fully determined yet. Since the strategy of increasing the dose of rifamycins is being evaluated for its treatment-shortening potential, additional in vitro modeling is important. Therefore, we assessed increased dosing of rifampin and rifapentine in our HFIM in order to gain more insight into the place of the HFIM in the drug development pipeline. Total and free-fraction concentrations corresponding to daily dosing of 2.7, 10, and 50 mg of rifampin/kg of body weight, as well as 600 mg and 1,500 mg rifapentine, were assessed in our HFIM using the Mycobacterium tuberculosis H37Rv strain. Drug activity and the emergence of drug resistance were assessed by CFU counting and subsequent mathematical modeling over 14 days, and pharmacokinetic exposures were checked. We found that increasing rifampin exposure above what is expected with the standard dose did not result in higher antimycobacterial activity. For rifapentine, only the highest concentration showed increased activity, but the clinical relevance of this observation is questionable. Moreover, for both drugs, the emergence of resistance was unrelated to exposure. In conclusion, in the simplest experimental setup, the results of the HFIM did not fully correspond to preexisting clinical data. The inclusion of additional parameters and readouts in this preclinical model could be of interest for proper assessment of the translational value of the HFIM.


Assuntos
Mycobacterium tuberculosis , Rifamicinas , Antituberculosos/farmacologia , Antituberculosos/uso terapêutico , Rifamicinas/farmacologia
2.
Ultrasound Obstet Gynecol ; 56(6): 872-878, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-31975510

RESUMO

OBJECTIVES: Arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) may contribute to the pathogenesis of pre-eclampsia (PE), but their role remains to be elucidated. Our aims were to evaluate the surrogates of AVP and ANP, C-terminal pro-AVP (copeptin) and mid-regional pro-ANP (MR-proANP), as biomarkers for the prediction of PE-related pregnancy complications and whether they are associated with angiogenic markers and/or clinical manifestations of PE. METHODS: This was a retrospective analysis of a prospective cohort study that enrolled pregnant women with suspected or confirmed PE, between December 2013 and April 2016. From each patient, a blood sample was obtained at study entry and serum levels of copeptin, MR-proANP, soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) were measured. We evaluated the ability of sFlt-1, PlGF, sFlt-1/PlGF ratio, copeptin and MR-proANP, assessed either alone or combined with traditional predictors (gestational age, parity, diastolic blood pressure and proteinuria), to predict maternal complications and fetal/neonatal complications. Models were compared using concordance statistic (C-index). RESULTS: A total of 526 women were evaluated in the study. Women with confirmed PE displayed elevated serum copeptin and MR-proANP levels in comparison to those with suspected PE but no hypertensive disease of pregnancy. When combined with traditional predictors, the sFlt-1/PlGF ratio displayed a higher C-index than copeptin and MR-proANP (0.76, 0.63 and 0.67, respectively, vs 0.60 for the traditional predictors alone) for the prediction of maternal complications. Similarly, for the prediction of fetal/neonatal complications, the sFlt-1/PlGF ratio displayed a higher C-index than copeptin and MR-proANP when added to the traditional model (0.83, 0.79 and 0.80, respectively, vs 0.79 for the traditional predictors alone). When subdividing women according to sFlt-1/PlGF ratio (≥ 85 vs < 85), no differences in copeptin levels were observed, while MR-proANP level was elevated in women with sFlt-1/PlGF ratio ≥ 85. Multiple regression analysis revealed that copeptin and MR-proANP were independent determinants of proteinuria. CONCLUSIONS: Copeptin and MR-proANP have limited value in predicting PE-related complications when compared with the sFlt-1/PlGF ratio. However, both copeptin and MR-proANP were associated with proteinuria, with copeptin exerting this effect independently of the sFlt-1/PlGF ratio. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Fator Natriurético Atrial/sangue , Glicopeptídeos/sangue , Testes para Triagem do Soro Materno/estatística & dados numéricos , Pré-Eclâmpsia/sangue , Pré-Eclâmpsia/diagnóstico , Adulto , Biomarcadores/sangue , Feminino , Idade Gestacional , Humanos , Testes para Triagem do Soro Materno/métodos , Fator de Crescimento Placentário/sangue , Valor Preditivo dos Testes , Gravidez , Estudos Prospectivos , Estudos Retrospectivos , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/sangue
3.
Public Health ; 185: 161-166, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32634607

RESUMO

OBJECTIVE: The objective of this study was to summarize the results of the 2018 the Netherlands' Physical Activity Report Card (PARC) for children and youth as well as for children and youth with a chronic medical condition (CMC; PARC+). STUDY DESIGN: This study is a survey. METHODS: A total of 12 indicators were graded using the Active Healthy Kids Global Alliance PARC development process, which includes a synthesis of the best available research, surveillance, policy and practice findings and expert consensus. Grades were based on the best available evidence and ranged from grade A (>80% of the children succeed) to grade F (less than 20% succeed) or incomplete (INC). Sources included national surveys, peer-reviewed literature and grey literature such as government and non-government reports and online content. RESULTS: Grades assigned for PARC/PARC+ were as follows: Overall Physical Activity: C-/D+; Organized Sports Participation: B/B-; Active Play: D/D; Active Transportation: A-/B+; Sedentary Behaviour: D/D; Physical Fitness: INC /INC; Family and Peers: C/INC; School: C+/A-; Community and Environment: INC /INC; Government: INC /INC; Sleep: A-/B+ and Weight Status: A-/A-, respectively. CONCLUSIONS: The report shows that the Netherlands' youth scores well on (organized) participation in sports and active transport to and from school. However, they do not participate enough in overall physical activity. Despite the fact that outdoor play is the most important exercise activity for children, outdoor play scores an insufficient score for both healthy children and children with a CMC. Sports participation also contributed significantly to daily physical activity. However, sports participation alone is not enough to comply with the national activity guidelines.


Assuntos
Doença Crônica/epidemiologia , Exercício Físico , Relatório de Pesquisa , Adolescente , Peso Corporal , Criança , Pré-Escolar , Feminino , Política de Saúde , Promoção da Saúde , Humanos , Masculino , Países Baixos/epidemiologia , Grupo Associado , Aptidão Física , Jogos e Brinquedos , Instituições Acadêmicas , Comportamento Sedentário , Esportes , Inquéritos e Questionários
4.
Int J Obes (Lond) ; 43(11): 2189-2199, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-30979972

RESUMO

BACKGROUND: Obesity adversely affects health and is associated with subclinical systemic inflammation and features of accelerated aging, including the T-cell immune system. The presence of metabolic syndrome (MetS) may accelerate, while bariatric surgery might reverse these phenomena. To examine the effects of MetS and bariatric surgery on T-cell aging, we measured relative telomere length (RTL) and T-cell differentiation status in obese patients before and after bariatric surgery. METHODS: WHO II/III classified obese patients scheduled for bariatric surgery were included: 41 without MetS and 67 with MetS. RTL and T-cell differentiation status were measured in circulating CD4+ and CD8+ T cells via flow cytometry. T-cell characteristics were compared between patients with and without MetS prior to and at 3, 6, and 12 months after surgery considering effects of age, cytomegalovirus-serostatus, and weight loss. RESULTS: Thymic output, represented by numbers of CD31-expressing naive T cells, showed an age-related decline in patients with MetS. MetS significantly enhanced CD8+ T-cell differentiation. Patients with MetS had significant lower CD4+ RTL than patients without MetS. Within the first 6 months after bariatric surgery, RTL increased in CD4+ T cells after which it decreased at month 12. A decline in both thymic output and more differentiated T cells was seen following bariatric surgery, more pronounced in the MetS group and showing an association with percentage of body weight loss. CONCLUSIONS: In obese patients, MetS results in attrition of RTL and accelerated T-cell differentiation. Bariatric surgery temporarily reverses these effects. These data suggest that MetS is a risk factor for accelerated aging of T cells and that MetS should be a more prominent factor in the decision making for eligibility for bariatric surgery.


Assuntos
Cirurgia Bariátrica , Senescência Celular/fisiologia , Obesidade , Linfócitos T/fisiologia , Telômero/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Síndrome Metabólica , Pessoa de Meia-Idade , Obesidade/metabolismo , Obesidade/fisiopatologia , Obesidade/cirurgia , Estudos Prospectivos , Adulto Jovem
5.
Med Microbiol Immunol ; 208(3-4): 305-321, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30949763

RESUMO

Latent infection with cytomegalovirus (CMV) is thought to accelerate aging of the immune system. With age, influenza vaccine responses are impaired. Although several studies investigated the effect of CMV infection on antibody responses to influenza vaccination, this led to contradicting conclusions. Therefore, we investigated the relation between CMV infection and the antibody response to influenza vaccination by performing a systematic review and meta-analysis. All studies on the antibody response to influenza vaccination in association with CMV infection were included (n = 17). The following outcome variables were extracted: (a) the geometric mean titer pre-/post-vaccination ratio (GMR) per CMV serostatus group, and in addition (b) the percentage of subjects with a response per CMV serostatus group and (c) the association between influenza- and CMV-specific antibody titers. The influenza-specific GMR revealed no clear evidence for an effect of CMV seropositivity on the influenza vaccine response in young or old individuals. Meta-analysis of the response rate to influenza vaccination showed a non-significant trend towards a negative effect of CMV seropositivity. However, funnel plot analysis suggests that this is a consequence of publication bias. A weak negative association between CMV antibody titers and influenza antibody titers was reported in several studies, but associations could not be analyzed systematically due to the variety of outcome variables. In conclusion, by systematically integrating the available studies, we show that there is no unequivocal evidence that latent CMV infection affects the influenza antibody response to vaccination. Further studies, including the level of CMV antibodies, are required to settle on the potential influence of latent CMV infection on the influenza vaccine response.


Assuntos
Formação de Anticorpos , Infecções por Citomegalovirus/imunologia , Vacinas contra Influenza/imunologia , Orthomyxoviridae/imunologia , Latência Viral , Anticorpos Antivirais/sangue , Citomegalovirus/imunologia , Infecções por Citomegalovirus/virologia , Humanos , Imunossenescência , Vacinas contra Influenza/administração & dosagem
6.
Int J Obes (Lond) ; 42(2): 260-269, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28852207

RESUMO

BACKGROUND/OBJECTIVES: In obesity, B cells accumulate in white adipose tissue (WAT) and produce IgG, which may contribute to the development of glucose intolerance. IgG signals by binding to Fcγ receptors (FcγR) and by activating the complement system. The aim of our study was to investigate whether activation of FcγR and/or complement C3 mediates the development of high-fat diet-induced glucose intolerance. METHODS: We studied mice lacking all four FcγRs (FcγRI/II/III/IV-/-), only the inhibitory FcγRIIb (FcγRIIb-/-), only the central component of the complement system C3 (C3-/-), and mice lacking both FcγRs and C3 (FcγRI/II/III/IV/C3-/-). All mouse models and wild-type controls were fed a high-fat diet (HFD) for 15 weeks to induce obesity. Glucose metabolism was assessed and adipose tissue was characterized for inflammation and adipocyte functionality. RESULTS: In obese WAT of wild-type mice, B cells (+142%, P<0.01) and IgG (+128% P<0.01) were increased compared to lean WAT. Macrophages of FcγRI/II/III/IV-/-mice released lower levels of cytokines compared to wild-type mice upon IgG stimulation. Only C3-/- mice showed reduced HFD-induced weight gain as compared to controls (-18%, P<0.01). Surprisingly, FcγRI/II/III/IV-/- mice had deteriorated glucose tolerance (AUC +125%, P<0.001) despite reduced leukocyte number (-30%, P<0.05) in gonadal WAT (gWAT), whereas glucose tolerance and leukocytes within gWAT in the other models were unaffected compared to controls. Although IgG in gWAT was increased (+44 to +174%, P<0.05) in all mouse models lacking FcγRIIb, only FcγRI/II/III/IV/C3-/- mice exhibited appreciable alterations in immune cells in gWAT, for example, increased macrophages (+36%, P<0.001). CONCLUSIONS: Lack of FcγRs reduces the activity of macrophages upon IgG stimulation, but neither FcγR nor C3 deficiency protects against HFD-induced glucose intolerance or reduces adipose tissue inflammation. This indicates that if obesity-induced IgG contributes to the development of glucose intolerance, this is not mediated by FcγR or complement activation.


Assuntos
Tecido Adiposo Branco/metabolismo , Complemento C3/metabolismo , Intolerância à Glucose/metabolismo , Inflamação/metabolismo , Obesidade/metabolismo , Receptores de IgG/metabolismo , Animais , Células Cultivadas , Dieta Hiperlipídica , Modelos Animais de Doenças , Inflamação/fisiopatologia , Masculino , Camundongos , Camundongos Knockout , Obesidade/fisiopatologia
7.
Psychooncology ; 27(4): 1150-1161, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29361206

RESUMO

OBJECTIVE: This individual patient data (IPD) meta-analysis aimed to evaluate the effects of psychosocial interventions (PSI) on quality of life (QoL), emotional function (EF), and social function (SF) in patients with cancer, and to study moderator effects of demographic, clinical, personal, and intervention-related characteristics. METHODS: Relevant studies were identified via literature searches in 4 databases. We pooled IPD from 22 (n = 4217) of 61 eligible randomized controlled trials. Linear mixed-effect model analyses were used to study intervention effects on the post-intervention values of QoL, EF, and SF (z-scores), adjusting for baseline values, age, and cancer type. We studied moderator effects by testing interactions with the intervention for demographic, clinical, personal, and intervention-related characteristics, and conducted subsequent stratified analyses for significant moderator variables. RESULTS: PSI significantly improved QoL (ß = 0.14,95%CI = 0.06;0.21), EF (ß = 0.13,95%CI = 0.05;0.20), and SF (ß = 0.10,95%CI = 0.03;0.18). Significant differences in effects of different types of PSI were found, with largest effects of psychotherapy. The effects of coping skills training were moderated by age, treatment type, and targeted interventions. Effects of psychotherapy on EF may be moderated by cancer type, but these analyses were based on 2 randomized controlled trials with small sample sizes of some cancer types. CONCLUSIONS: PSI significantly improved QoL, EF, and SF, with small overall effects. However, the effects differed by several demographic, clinical, personal, and intervention-related characteristics. Our study highlights the beneficial effects of coping skills training in patients treated with chemotherapy, the importance of targeted interventions, and the need of developing interventions tailored to the specific needs of elderly patients.


Assuntos
Ajustamento Emocional , Neoplasias/psicologia , Neoplasias/reabilitação , Reabilitação Psiquiátrica/psicologia , Psicoterapia , Qualidade de Vida/psicologia , Ajustamento Social , Adulto , Idoso , Feminino , Humanos , Individualidade , Masculino , Pessoa de Meia-Idade , Reabilitação Psiquiátrica/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Int J Obes (Lond) ; 39(5): 782-90, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25394307

RESUMO

BACKGROUND: Immune processes contribute to the development of obesity and its complications, such as insulin resistance, type 2 diabetes mellitus and cardiovascular disease. Approaches that target the inflammatory response are promising therapeutic strategies for obesity. In this context, we recently demonstrated that the interaction between the costimulatory protein CD40 and its downstream adaptor protein tumor necrosis factor receptor-associated factor 6 (TRAF6) promotes adipose tissue inflammation, insulin resistance and hepatic steatosis in mice in the course of diet-induced obesity (DIO). METHODS: Here we evaluated the effects of a small-molecule inhibitor (SMI) of the CD40-TRAF6 interaction, SMI 6860766, on the development of obesity and its complications in mice that were subjected to DIO. RESULTS: Treatment with SMI 6860766 did not result in differences in weight gain, but improved glucose tolerance. Moreover, SMI 6860766 treatment reduced the amount of CD45(+) leucocytes in the epididymal adipose tissue by 69%. Especially, the number of adipose tissue CD4(+) and CD8(+) T cells, as well as macrophages, was significantly decreased. CONCLUSIONS: Our results indicate that small-molecule-mediated inhibition of the CD40-TRAF6 interaction is a promising therapeutic strategy for the treatment of metabolic complications of obesity by improving glucose tolerance, by reducing the accumulation of immune cells to the adipose tissue and by skewing of the immune response towards a more anti-inflammatory profile.


Assuntos
Tecido Adiposo/metabolismo , Compostos de Anilina/farmacologia , Antígenos CD40/antagonistas & inibidores , Linfócitos T CD8-Positivos/metabolismo , Inflamação/metabolismo , Obesidade/complicações , Propiofenonas/farmacologia , Transdução de Sinais/efeitos dos fármacos , Fator 6 Associado a Receptor de TNF/antagonistas & inibidores , Animais , Células Cultivadas , Diabetes Mellitus Tipo 2/metabolismo , Dieta Hiperlipídica , Citometria de Fluxo , Resistência à Insulina , Macrófagos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Obesidade/etiologia , Obesidade/metabolismo
9.
BMC Genet ; 16: 146, 2015 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-26698836

RESUMO

BACKGROUND: The use of information across populations is an attractive approach to increase the accuracy of genomic prediction for numerically small populations. However, accuracies of across population genomic prediction, in which reference and selection individuals are from different populations, are currently disappointing. It has been shown for within population genomic prediction that Bayesian variable selection models outperform GBLUP models when the number of QTL underlying the trait is low. Therefore, our objective was to identify across population genomic prediction scenarios in which Bayesian variable selection models outperform GBLUP in terms of prediction accuracy. In this study, high density genotype information of 1033 Holstein Friesian, 105 Groningen White Headed, and 147 Meuse-Rhine-Yssel cows were used. Phenotypes were simulated using two changing variables: (1) the number of QTL underlying the trait (3000, 300, 30, 3), and (2) the correlation between allele substitution effects of QTL across populations, i.e. the genetic correlation of the simulated trait between the populations (1.0, 0.8, 0.4). RESULTS: The accuracy obtained by the Bayesian variable selection model was depending on the number of QTL underlying the trait, with a higher accuracy when the number of QTL was lower. This trend was more pronounced for across population genomic prediction than for within population genomic prediction. It was shown that Bayesian variable selection models have an advantage over GBLUP when the number of QTL underlying the simulated trait was small. This advantage disappeared when the number of QTL underlying the simulated trait was large. The point where the accuracy of Bayesian variable selection and GBLUP became similar was approximately the point where the number of QTL was equal to the number of independent chromosome segments (M e ) across the populations. CONCLUSION: Bayesian variable selection models outperform GBLUP when the number of QTL underlying the trait is smaller than M e . Across populations, M e is considerably larger than within populations. So, it is more likely to find a number of QTL underlying a trait smaller than M e across populations than within population. Therefore Bayesian variable selection models can help to improve the accuracy of across population genomic prediction.


Assuntos
Teorema de Bayes , Bovinos/genética , Modelos Genéticos , Locos de Características Quantitativas , Animais , Bovinos/classificação , Genética Populacional , Polimorfismo de Nucleotídeo Único
10.
Fam Cancer ; 23(3): 255-265, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38822936

RESUMO

Individuals with a germline CDKN2A pathogenic variant (PV) have a highly increased life time risk of melanoma and pancreatic cancer. This cross-sectional study assessed the attitudes among toward genetic testing, family planning, and preimplantation genetic testing (PGT) in confirmed CDKN2A PV carriers and individuals with a 50% risk of the PV (at-risk carriers) using of a one-time questionnaire.A total of 537 individuals were screened for eligibility, of whom 208 of 366 (57%) confirmed carriers (56% female, median age 54 years [IQR 46-63]) and 39 of 171 (23%) at-risk carriers (59% female, median age of 26 years [IQR 22-32]) participated in the study. Primary motivations for genetic testing were to gain control over their personal and children's cancer risk, as well as increasing cancer surveillance practices. In contrast, concerns about obtaining a mortgage and life insurance were frequently cited as reasons for postponing genetic testing. Family planning decisions remained largely unaffected in both confirmed and at-risk carriers; however, the majority of confirmed carriers were still unaware of their familial or personal cancer risk when starting a family. More than 60% of the participants were unfamiliar with PGT and only a minority (19% of confirmed carriers and 10% of at-risk carriers) would be open to considering PGT as a reproductive option. This study found different attitudes toward genetic testing, family planning, and PGT among individuals affected by the CDKN2A PV. Understanding these different attitudes can help clinicians to address the complexities surrounding these issues, especially for younger individuals facing difficult decisions about the timing of genetic testing, family planning, and the potential use of assisted reproductive options.


Assuntos
Inibidor p16 de Quinase Dependente de Ciclina , Serviços de Planejamento Familiar , Predisposição Genética para Doença , Testes Genéticos , Mutação em Linhagem Germinativa , Diagnóstico Pré-Implantação , Humanos , Feminino , Pessoa de Meia-Idade , Adulto , Masculino , Estudos Transversais , Diagnóstico Pré-Implantação/psicologia , Predisposição Genética para Doença/psicologia , Inibidor p16 de Quinase Dependente de Ciclina/genética , Adulto Jovem , Melanoma/genética , Melanoma/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos e Questionários , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/psicologia , Inibidor de Quinase Dependente de Ciclina p18/genética
11.
Diabetologia ; 56(7): 1520-30, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23620057

RESUMO

AIMS/HYPOTHESIS: Consumption of sugar-sweetened beverages has been shown, largely in American populations, to increase type 2 diabetes incidence. We aimed to evaluate the association of consumption of sweet beverages (juices and nectars, sugar-sweetened soft drinks and artificially sweetened soft drinks) with type 2 diabetes incidence in European adults. METHODS: We established a case-cohort study including 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants selected from eight European cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. After exclusions, the final sample size included 11,684 incident cases and a subcohort of 15,374 participants. Cox proportional hazards regression models (modified for the case-cohort design) and random-effects meta-analyses were used to estimate the association between sweet beverage consumption (obtained from validated dietary questionnaires) and type 2 diabetes incidence. RESULTS: In adjusted models, one 336 g (12 oz) daily increment in sugar-sweetened and artificially sweetened soft drink consumption was associated with HRs for type 2 diabetes of 1.22 (95% CI 1.09, 1.38) and 1.52 (95% CI 1.26, 1.83), respectively. After further adjustment for energy intake and BMI, the association of sugar-sweetened soft drinks with type 2 diabetes persisted (HR 1.18, 95% CI 1.06, 1.32), but the association of artificially sweetened soft drinks became statistically not significant (HR 1.11, 95% CI 0.95, 1.31). Juice and nectar consumption was not associated with type 2 diabetes incidence. CONCLUSIONS/INTERPRETATION: This study corroborates the association between increased incidence of type 2 diabetes and high consumption of sugar-sweetened soft drinks in European adults.


Assuntos
Bebidas/estatística & dados numéricos , Diabetes Mellitus Tipo 2/epidemiologia , Adulto , Bebidas Gaseificadas/estatística & dados numéricos , Europa (Continente)/epidemiologia , Feminino , Humanos , Incidência , Masculino , Edulcorantes
12.
Diabetologia ; 56(1): 47-59, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22983636

RESUMO

AIMS/HYPOTHESIS: A diet rich in meat has been reported to contribute to the risk of type 2 diabetes. The present study aims to investigate the association between meat consumption and incident type 2 diabetes in the EPIC-InterAct study, a large prospective case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: During 11.7 years of follow-up, 12,403 incident cases of type 2 diabetes were identified among 340,234 adults from eight European countries. A centre-stratified random subsample of 16,835 individuals was selected in order to perform a case-cohort design. Prentice-weighted Cox regression analyses were used to estimate HR and 95% CI for incident diabetes according to meat consumption. RESULTS: Overall, multivariate analyses showed significant positive associations with incident type 2 diabetes for increasing consumption of total meat (50 g increments: HR 1.08; 95% CI 1.05, 1.12), red meat (HR 1.08; 95% CI 1.03, 1.13) and processed meat (HR 1.12; 95% CI 1.05, 1.19), and a borderline positive association with meat iron intake. Effect modifications by sex and class of BMI were observed. In men, the results of the overall analyses were confirmed. In women, the association with total and red meat persisted, although attenuated, while an association with poultry consumption also emerged (HR 1.20; 95% CI 1.07, 1.34). These associations were not evident among obese participants. CONCLUSIONS/INTERPRETATION: This prospective study confirms a positive association between high consumption of total and red meat and incident type 2 diabetes in a large cohort of European adults.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Dieta/efeitos adversos , Carne/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etnologia , Dieta/etnologia , Europa (Continente)/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Ferro da Dieta/administração & dosagem , Ferro da Dieta/efeitos adversos , Masculino , Carne/análise , Produtos da Carne/efeitos adversos , Produtos da Carne/análise , Pessoa de Meia-Idade , Estudos Prospectivos , Risco , Caracteres Sexuais , Adulto Jovem
13.
J Hosp Infect ; 131: 173-180, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36328310

RESUMO

BACKGROUND: Observing hand hygiene compliance (HHC) among non-sterile healthcare workers (HCWs) in the operating theatre (OT) is challenging as there are no tailored protocols or observation tools. AIM: To develop and test a hand hygiene protocol tailored to non-sterile HCWs in the OT. METHODS: In this prospective observational study, nine hospitals in the Rotterdam-Rijnmond region provided input on a draft protocol on hand hygiene in the OT, resulting in a new consensus protocol for the region. An observation tool based on the protocol was developed and tested. HHC rates with 95% confidence intervals (CI) were calculated by type of hospital and type of HCW. FINDINGS: The protocol has three sections: (1) written general hand hygiene rules; (2) written hand hygiene rules specific for anaesthesia and surgery; and (3) visual representation of the OT, divided into four hand hygiene areas. Hand hygiene should be applied when changing area. Average HHC of 48.0% (95% CI 45.2-61.2%) was observed in OTs across all hospitals. HHC was highest in the two specialized hospitals (64.0%, 95% CI 30.6-89.8%; 76.7%, 95% CI 62.8-84.5%) and lowest in the academic teaching hospital (23.1%, 95% CI 0.0-45.8%). In terms of type of HCW, HHC was lowest among anaesthesiologists (31.6%, 95% CI 19.2-62.4%) and highest among OT assistants (57.4%, 95% CI 50.1-78.2%). CONCLUSION: This uniform way of observing HHC in the OT enables evaluation of the effectiveness of interventions in the OT and facilitates friendly competition. In the Rotterdam-Rijnmond region, HHC in the OT was below 50%; this needs to be addressed, particularly in teaching hospitals and among physicians.


Assuntos
Infecção Hospitalar , Higiene das Mãos , Humanos , Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes , Desinfecção das Mãos , Higiene das Mãos/métodos , Pessoal de Saúde , Hospitais de Ensino , Estudos Observacionais como Assunto , Salas Cirúrgicas
14.
Endocr Connect ; 12(3)2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36524811

RESUMO

Objective: The primary objective of this study is to establish maternal reference values of anti-Müllerian hormone (AMH) in a fertile multi-ethnic urban pregnant population and to evaluate the effect of gestational age. The secondary objective of this study is to explore the association between AMH and placental biomarkers. Design: This study was embedded in the Generation R Study, an ongoing population-based prospective cohort study from early pregnancy onwards. Setting: City of Rotterdam, the Netherlands, out of hospital setting. Patients: In 5806 women, serum AMH levels were determined in early pregnancy (median 13.5 weeks; 95% range 10.5-17.2). Intervention(s): None. Main outcome measures: Maternal AMH levels in early pregnancy and its association with placental biomarkers, including human chorionic gonadotrophin (hCG), soluble fms-like tyrosine kinase-1 (sFLT), and placental growth factor (PLGF). Results: A nomogram of AMH in early pregnancy was developed. Serum AMH levels showed a decline with advancing gestational age. Higher AMH levels were associated with a higher level of the placental biomarkers hCG and sFLT in early pregnancy. This last association was predominantly mediated by hCG. AMH levels were negatively associated with PLGF levels. Conclusion: In this large study, we show that AMH levels in early pregnancy decrease with advancing gestational age. The association between AMH and the placental biomarkers hCG, sFLT, and PLGF suggests a better placental development with lower vascular resistance in mothers with higher AMH levels. Hence, AMH might be useful in predicting adverse pregnancy outcomes due to impaired placental development.

15.
Phys Rev Lett ; 108(18): 183901, 2012 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-22681076

RESUMO

We demonstrate a new technique for absolute distance measurement with a femtosecond frequency comb laser, based on unraveling the output of an interferometer to distinct comb modes with 1 GHz spacing. From the fringe patterns that are captured with a camera, a distance is derived by combining spectral and homodyne interferometry, exploiting about 9000 continuous wave lasers. This results in a measurement accuracy far within an optical fringe (λ/30), combined with a large range of nonambiguity (15 cm). Our technique merges multiwavelength interferometry and spectral interferometry, within a single scheme.

16.
Opt Express ; 19(7): 6549-62, 2011 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-21451683

RESUMO

We experimentally demonstrate long distance measurements with a femtosecond frequency comb laser using dispersive interferometry. The distance is derived from the unwrapped spectral phase of the dispersed interferometer output and the repetition frequency of the laser. For an interferometer length of 50 m this approach has been compared to an independent phase counting laser interferometer. The obtained mutual agreement is better than 1.5 µm (3×10(-8)), with a statistical averaging of less than 200 nm. Our experiments demonstrate that dispersive interferometry with a frequency comb laser is a powerful method for accurate and non-incremental measurement of long distances.


Assuntos
Algoritmos , Interferometria/instrumentação , Lasers , Processamento de Sinais Assistido por Computador/instrumentação , Desenho de Equipamento , Análise de Falha de Equipamento
17.
Opt Express ; 19(4): 3406-17, 2011 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-21369163

RESUMO

We investigate general properties of the interferograms from a frequency comb laser in a non-linear dispersive medium. The focus is on interferograms at large delay distances and in particular on their broadening, the fringe formation and shape. It is observed that at large delay distances the interferograms spread linearly and that its shape is determined by the source spectral profile. It is also shown that each intensity point of the interferogram is formed by the contribution of one dominant stationary frequency. This stationary frequency is seen to vary as a function of the path length difference even within the interferogram. We also show that the contributing stationary frequency remains constant if the evolution of a particular fringe is followed in the successive interferograms found periodically at different path length differences. This can be used to measure very large distances in dispersive media.

18.
J S Afr Vet Assoc ; 82(4): 194-204, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22616432

RESUMO

This study involves the evaluation of pre-purchase radiographic studies of South African Thoroughbred yearlings. Radiographic changes were recorded and compared with similar international studies. The study differs from other studies in that a lower prevalence of pedal osteitis (1.26%), dorsal osteochondral fragmentation of the metatarsophalangeal joint (1.60%), distal metacarpal sagittal ridge changes (15.7%), ulnar carpal bone lucencies (8.33%), carpal osteophytes (1.19%), distal intertarsal and tarsometatarsal joint radiographic changes (9.92%), tarsal osteochondrosis lesions (4.40%) and stifle osteochondrosis lesions (0.4%) was found. The prevalence of dorsal osteochondral fragments in the metacarpophalangeal joint was similar to other studies (1.60%). A higher prevalence of vascular channels as well as irregular borders and lucencies was evident in the proximal sesamoid bones. There was a higher prevalence of palmar metacarpophalangeal and plantar metatarsophalangeal osteochondral fragments (2% and 7.10% respectively). Palmar metacarpal disease, metacarpal supracondylar lysis, proximal sesamoid bone fractures and carpal osteochondral fragmentation were absent in the current study. Additional findings recorded in the current study were proximal interphalangeal joint hyperextension (left front 15.13%, right front 18.91%), the solar angle (right front 2.38 degrees, left front 2.79 degrees), the prevalence of carpal bone 1 (30.95%) and carpal bone 5 (1.59%). Management, nutrition and genetics in the various groups of Thoroughbred yearlings should be further investigated in order to explain the reasons for the differences recorded in the current study.


Assuntos
Comércio , Doenças dos Cavalos/diagnóstico por imagem , Cavalos/anatomia & histologia , Cavalos/fisiologia , Animais , Carpo Animal/diagnóstico por imagem , Feminino , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/economia , Doenças dos Cavalos/epidemiologia , Masculino , Prevalência , Radiografia , África do Sul , Joelho de Quadrúpedes/diagnóstico por imagem , Tarso Animal/diagnóstico por imagem
19.
J Intern Med ; 268(2): 133-44, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20210842

RESUMO

OBJECTIVE: Later life weight change and mortality amongst elders. DESIGN: Nested case-control study. SETTING: Six countries from the European Investigation into Cancer and nutrition-Elderly, Network on Ageing and Health. SUBJECTS: A total of 1712 deceased (cases) and 4942 alive (controls) were selected from 34,239 participants, > or = 60 years at enrolment (1992-2000) who were followed-up until March 2007. Annual weight change was estimated as the weight difference from recruitment to the most distant from-date-of-death re-assessment, divided by the respective time. OUTCOME MEASURES: Mortality in relation to weight change was examined using conditional logistic regression. RESULTS: Weight loss > 1 kg year(-1) was associated with statistically significant increased death risk (OR = 1.65; 95% CI: 1.41-1.92) compared to minimal weight change (+/-1 kg year(-1)). Weight gain > 1 kg year(-1) was also associated with increased risk of death (OR = 1.15; 95% CI: 0.98-1.37), but this was evident and statistically significant only amongst overweight/obese (OR = 1.55; 95% CI: 1.17-2.05). In analyses by time interval since weight re-assessment, the association of mortality with weight loss was stronger for the interval proximal (< 1 year) to death (OR = 3.10; 95% CI: 2.03-4.72). The association of mortality with weight gain was stronger at the interval of more than 3 years and statistically significant only amongst overweight/obese (OR = 1.58; 95% CI: 1.07-2.33). Similar patterns were observed regarding death from circulatory diseases and cancer. CONCLUSIONS: In elderly, stable body weight is a predictor of lower subsequent mortality. Weight loss is associated with increased mortality, particularly short-term, probably reflecting underlying nosology. Weight gain, especially amongst overweight/obese elders, is also associated with increased mortality, particularly longer term.


Assuntos
Mortalidade , Redução de Peso , Adulto , Idoso , Antropometria/métodos , Índice de Massa Corporal , Estudos de Casos e Controles , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/mortalidade , Prognóstico , Estudos Prospectivos , Aumento de Peso
20.
J Magn Reson Imaging ; 31(5): 1252-5, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20432364

RESUMO

PURPOSE: To apply magnetic resonance imaging (MRI) as a tool for quantifying muscle volume of forearm muscles feasibility and reliability of volume estimation of the flexor carpi ulnaris (FCU) and the extensor carpi ulnaris (ECU). MATERIALS AND METHODS: Forearms of 10 subjects were scanned twice. Muscle volumes were calculated from manual outlines on axial slices, slice thickness, and the number of slices. Observer agreement and repeatability were estimated using intraclass correlation, coefficient of variation, and the smallest detectable difference. RESULTS: The average volume of the FCU and ECU was 31.0 mL (SD 11.5 mL) and 16.4 mL (SD 7.7 mL), respectively. Intraclass correlation coefficients of the volumes were all above 0.99 and the coefficient of variation varied between 5.7% and 0.8%. The smallest detectable difference corresponded to approximately 7% of muscle volume. CONCLUSION: MRI muscle volume measurement of forearm muscles is feasible, reproducible, and allows for longitudinal studies where expected responsiveness exceeds 7%.


Assuntos
Antebraço/anatomia & histologia , Imageamento por Ressonância Magnética/métodos , Músculo Esquelético/anatomia & histologia , Adulto , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
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